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Hepatitis B virus-related cirrhosis is the result of Chronic Hepatitis B development .Now,many studying has shown :HBV induced hepatic immune injury is one of the important factors inducing hepatic cirrhosis.The persistent copying of HBV DNA is star-up causation of the liver inflammation,damnification and fibrosis.Antiviral treatment is the key of treating patients with decompensated cirrhosis due to chronic hepatitis B.Entecavir is one of the nucleoside analog.It has the most rapid action,the strongest curative effect and the lowest ratio of drug resistance.Entecavir has shown better superiority in treating patients with decompensated hepatitis B virus-related cirrhosis.Objective:To evaluate the efficacy and safety of entecavir in patients with decompensated hepatitis B virus-related cirrhosis.Methods:In this study,we assigned 42 patients with decompensated hepatitis B virus-related cirrhosis to received 0.5 mg of entecavir(n=22),0r common therapy (n=20) for 72 weeks.ALT,HBV DNA,HBeAg, ALB,TBIL, PTA and Child-Pugh score were quantified at baseline and at 12,24,48,72 weeks.Results:1. The mean levels of entecavir group HBV DNA was(7.34±0.54)log10 copies/ml at baseline,At week 12 weeks ,the mean decreasing levels of HBV DNA in entecavir group was(2.68±0.53)log10 copies/ml, entecavir group had better efficacy(P<0.05). Compared wih the base line, the efficacy of 12-week entecavir therapy was better in ALT,ALB, TBIL and PTA. Compared wih the control group, the efficacy of entecavir group was better.2. At week 24, more patients in entecavir group than in control group achieved normal ALT (72.73% vs 20%, P < 0.05 ).More patients in entecavir group than in control group achieved undetectable serum HBV DNA level (13.24% vs 5%, P > 0.05 ) (Undetectable serum HBV DNA level was < 500 copies/ml ). The ratio of entecavir group was higher than in control group,but the result was not statistically significant.3. At week 48,the mean level of entecavir group HBV DNA was(2.81±0.21)log10 copies/ml,the mean level of control group HBV DNA was(7.04±0.66)log10 copies/ml. The mean decreasing range of HBV DNA in entecavir group was (4.52±0.55)log10 copies/ml.The result was statistically significant. (t=-28.67,P<0.001). More patients in entecavir group than in control group achieved undetectable serum HBV DNA level (81.82% vs 5%, P < 0.01 ).More patients in entecavir group than in control group achieved normal ALT (95.45% vs 35%, P < 0.01). Among the HBeAg positive patients,more patients in entecavir group than in control group had HBeAg los(s21.43% vs 5.89%),but the result was not statistically significant (P>0.05).The entecavior group had achieved better curative effect in ALT,ALB,TBIL,PTA,and Child-Pugh score (P < 0.05).4. At week 72,more patients in entecavir group than in control group had achieved undetectable serum HBV DNA level (90.9% vs 5%, P < 0.01 ).More patients in entecavir group than in control group had achieved normal ALT (95.45% vs 35%, P < 0.01 ). The ratio of HBeAg loss in the entecavir group was higher than in the control group(28.57% vs 5.89%, P <0.05).5. The incidence of ascites in entecavir group was lower than in control group(9.10% vs 55%, P < 0.01 ); The incidences of hepatocellular carcinoma(HCC) of two groups were not not statistically significant (4.55% vs 15%, P < 0.01 ); The fatality rates of two groups were not statistically significant (9.10% vs 15%, P < 0.01 ).Conclusions: The 72-week entecavir treatment resulted in virus suppression.The entecavir treatment could decrease the level of HBV DNA ,improve liver function ,inhibit HBV replication and make the ratio of HBeAg loss higher in patients with HBV related cirrhosis.In treatment of the patients with decompensated hepatitis B virus-related cirrhosis, entecavir is effective in suppressing the replication of HBV and delaying the progression of fibrosis,and it is safe for patients.
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